Make way, Invisalign (though, we do love you!), there are some trending treatments to get on your radar! From 3D-printed appliances for teeth grinding to scalpel-free surgery to new teeth scaling technology, here’s a look at the latest in dentistry – and how your teeth can benefit from the most modern advancements at dental clinics in Singapore. So, if you’re looking for teeth whitening treatment, pain-free teeth scaling solutions, toxin-free fillings or techniques to stop teeth grinding, see what these Singapore dentists can offer!
3D-printed dental splints for teeth grinding
Over the last three years, teeth grinding – known as bruxism – has been on the rise, with dentists seeing an influx of patients with sensitive, cracked and chipped teeth since the start of the pandemic.
Teeth grinding can be treated using dental splints to reposition the jaw, thus reducing stress and pain in the temporomandibular joint (TMJ). These dental splints usually take up to one to two weeks to manufacture in a lab. And, with the rise in teeth grinding cases over the last few years, the turnaround times for such dental appliances have grown even longer, says the team at Expat Dental, a holistic dental clinic in Singapore for the entire family. These three- to four-week turnaround times delay treatment for patients, putting them at risk of further damage to their teeth.
But, thanks to advancements in digital dentistry, it’s now possible for dental splints for bruxism treatment to be produced in-clinic at Expat Dental’s Raffles Place practice, using 3D printing technology. In fact, the dental clinic is the first in Singapore to use its in-house NextDent 5100 3D printer to manufacture splints made from NextDent Ortho Flex resin, which offers more flexibility than the bulkier resins traditionally used in dental splints for teeth grinding.
“In today’s age of digital dentistry, the NextDent Ortho Flex resin presents a new dawn for the future of dentistry, paving the way for 3D printing innovation, dental technologies and dental care industries,” says DR SHAUN THOMPSON, managing director at Expat Dental.
Not only can the convenience of 3D technology make the entire restorative dentistry process more streamlined for patients, but the material itself can also improve the whole treatment experience. Certified by Singapore’s Health Sciences Authority, the newly launched NextDent Ortho Flex resin offers a more comfortable experience, making it easier for patients to wear the appliance while sleeping. This, in turn, means better compliance when it comes to actually wearing it.
A game changer in teeth scaling and polishing
Biofilm is a sticky, colourless coating that covers your teeth. It’s full of bad bacteria that cause gum disease and decay, explains dentist DR ANDREW DOIG of Skye Dental. Plaque is one type of biofilm that builds up in your mouth every day from food and bacteria.
While it’s completely normal for plaque to form, it must be removed daily with flossing and brushing. If it’s not removed effectively every day, the layer of bacteria builds up and hardens into tartar (dental calculus). This tartar makes it difficult to brush and floss effectively, thus increasing one’s risk of tooth decay and gum disease. And, once tartar has formed, it can’t be removed at home. It can only be removed by a dental professional using special tools for teeth scaling.
These tools have traditionally included manual scraping instruments, rubber cups and brushes, and abrasive pastes that have made for many less-than-comfortable experiences. Luckily, there is a more modern approach that cleans biofilm away, and takes the risk of dental decay and gum disease with it – minus the discomfort.
Called Guided Biofilm Therapy (GBT), the technique uses Airflow technology, heated water and a specially designed powder to remove biofilm even in hard- to-reach places, and clean and polish the teeth at the same time.
Though this Swiss technology was developed more than five years ago, it has not really been practised in Singapore until recently, says Dr Andrew. Dentists must be trained and certified as official providers of Guided Biofilm Therapy in order to perform the technique.
Skye Dental is among the dental clinics in Singapore that currently use GBT – and Dr Andrew says that the teeth scaling technology has been a total game changer in his dental clinic.
“GBT may sound like the name of a Korean pop group that your teen is into, but it’s the new scale and polish,” he says. “It is more effective for the removal of bacteria, hard tartar and stains than traditional methods because it uses a special dye to show all the ‘bad stuff’; there’s no hiding if it’s not cleaned off.”
There are other advantages of GBT, too. “It’s noninvasive and painless, and causes less sensitivity than the traditional teeth scaling methods. It uses a dedicated water supply that’s heated to 40 degrees Celsius; so, no more cold water on sensitive teeth!” says Dr Andrew.
“It’s also safer and scientifically proven not to damage your enamel, like the old-fashioned, abrasive polishing pastes, rubber cups and uncomfortable scratchy instruments do.”
What’s more, the teeth scaling and polishing procedure is gentle enough for anyone, including kids.
“I find Guided Biofilm Therapy particularly good for children and those with braces or Invisalign, as it helps identify brushing shortcomings and gives us an opportunity to improve them. The bonus is that it’s completely painless,” says Dr Andrew. “In fact, patients have said that it’s more like a spa experience than a cleaning!”
Dr Andrew routinely uses GBT for all of his patients, including those undergoing orthodontic treatment by his wife, Dr Eide. The entire process takes around 30 to 60 minutes, and can work perfectly as part of a routine dental cleaning every six months.
Scalpel-free gum restoration
Gum recession is the gradual loss of gum tissue as a result of ageing, gum disease or teeth brushing too vigorously. Once the gums have pulled away from the tooth, the root is left exposed, making it more susceptible to decay, infection and even tooth loss. It can also cause tooth sensitivity, which makes eating hot and cold food, and even teeth cleanings, particularly unpleasant. Needless to say, receding gums are far more than just a cosmetic concern.
What’s more, once the gums start to recede, they will not reattach to the teeth and the condition will only get worse over time. To repair the damaging effects of gum recession, gum graft procedures are typically performed by a periodontist. This involves taking a flap of gum tissue from the roof of the patient’s mouth, and stitching it to the entire area surrounding the exposed root. While this technique has proven to produce effective results, it certainly doesn’t make for the most comfortable post-op experience; the patient usually has sutures both on the roof of the mouth and where the missing tissue was replaced.
Luckily, there’s now a minimally invasive procedure that’s designed to stabilise and, possibly, reverse the gum recession process and restore gum lines without incisions, grafts or sutures. Known as Pinhole Gum Rejuvenation, the scalpel-free technique utilises specially designed instruments to loosen the gum tissue, then guide it over the exposed root surfaces. Results are instant, and, since there’s no cutting or stitching, patients can expect minimal to no downtime.
However, there are only a select number of dentists and dental clinics in Singapore who have been certified to perform Pinhole Gum Rejuvenation. Among those dentists is DR JAMES HO of G Plus Dental Center at Camden Medical Centre. Dr Ho even trained directly under Dr John Chao, the inventor of the minimally invasive gum lift method.
He says that, in addition to minimal downtime and less discomfort after treatment, patients can expect the results to be long-lasting and have a natural appearance. Plus, the procedure is quick; it can be done in as little as two hours, which means you can do it during lunchtime at the dental clinic!
You can schedule a consultation with G Plus Dental Center to see if you’re a good candidate for Pinhole Gum Rejuvenation.
Instant-result, light-activated teeth whitening treatments
For years, getting your teeth whitened involved soaking them in a hydrogen peroxide-based solution to remove stains over the course of multiple treatment sessions. Thanks to modern technology, that teeth whitening process has been streamlined, with lasers catalysing the chemical reaction of the hydrogen peroxide solution, and delivering whiter teeth in a lot less time than ever before.
One of the most popular laser teeth whitening treatments on the market today is Zoom teeth whitening. It’s an in-office treatment that involves applying specialised whitening gel to the teeth and using a special LED light to activate it.
According to DR BERNARD SIEW, an Australian trained dentist at Smilefocus, light-activated teeth whitening has the advantage of producing faster results compared to other methods such as at-home whitening kits. In fact, the Zoom technology, he says, has been clinically proven to lighten teeth up to eight shades whiter in just one visit. The entire process takes just two hours, and leaves patients with whiter, brighter smiles.
What’s more, he says the teeth whitening treatment is completely effective on healthy teeth, and the benefits may be seen for years. Of course, you’ll need to ensure your end of the bargain with proper upkeep. For instance, following the treatment, it’s best to avoid teeth-staining foods and drinks for the first 24 hours. “Anything that will stain a white t-shirt will stain your teeth!”
At-home treatment, updated
While light-activated teeth whitening treatment can work its magic in a single in-clinic session, take-home treatments have gotten their own proper updates in recent times as well. So, you can say goodbye to those whitening strips that don’t work, and you can bid adieu to relying on oil pulling alone.
In fact, Dr Siew says that at-home teeth whitening treatment, which involves wearing a customised mouth guard with whitening gel, can garner the same end result as the in-clinic technique; only, it will take longer to achieve those results.
“Although it’s a slower method, home whitening tends to produce more predictable results because of the amount of time the peroxide gel is in contact with the teeth,” he explains. For this reason, many of his patients prefer using the gel trays, and have seen improved colour in just a few days.
Regardless of the method you choose, you can bet that both are safe, noninvasive and effective, explains Dr Siew. The best place to start is a consult with your dentist, who can identify the cause of discolouration and determine the most appropriate treatment option for you.
Amalgam-free fillings is the new norm
Amalgam fillings or “silver fillings” are probably what come to mind when you think of a filling. Made up of 50 percent mercury and a mix of other metals, this type of filling has been widely used by dentists for over 150 years. But, with recent advancements, it’s no longer the only option. In fact, what was once the norm in restorative dentistry is now considered a passé practice by many, for various reasons.
Firstly, there is scientific evidence that the mercury in amalgam fillings can be harmful to the human body – and the environment. The mercury from amalgam fillings gets released over time, emitting a vapour that’s inhaled and absorbed into the bloodstream. This is thought to have damaging effects on the organs, particularly the brain, kidney, liver, lungs and gastrointestinal tract.
While this remains a hotly debated topic in the dental world, with some studies showing no direct correlation between amalgam and damaging health effects, organisations such as the World Health Organization, World Dental Federation and International Academy of Oral Medicine and Toxicology (IAOMT) support the decision to phase out amalgam use. This is in accordance with the Minamata Convention on Mercury – a global agreement that aims to reduce the negative impact of mercury on the environment and human health. And Singapore is among the countries to adopt this “phase-down” approach.
DR THEAN TSIN PIAO of Aesthete Smilestudio is an advocate of amalgam free treatment and is a member of the IAOMT. His dental clinic in Singapore has even been amalgam-free since day one, almost 20 years ago. He says that many of his patients who became aware of the possible health risks immediately came to the clinic to get their existing amalgam fillings removed and replaced – a process that isn’t as simple as you’d think, but one that Dr Thean is able to perform.
Because the drilling of amalgam fillings releases mercury vapour that can be inhaled by patients and dentists, only dental professionals who practise the SMART (Safe Mercury Amalgam Removal Technique) safety protocols can perform the procedure. So, if you have existing amalgam fillings and want to remove them, do make sure to see a dentist who is able to safely remove them.
You’ll likely want to choose composite or stronger ceramic fillings, which are tooth-coloured, creating a more aesthetically pleasing appearance than the metal filling look. Bonus points for the fact that resin composite fillings are just as durable and do not expand or contract to changes in temperature – thus increasing incidence of tooth fractures – like amalgam fillings can.
Zirconia crowns, made in the dental clinic
Dental crowns are an important type of dental restoration. Not only can they strengthen teeth that have been weakened due to caries or fractures, but they can also improve your smile by modifying tooth colour, position and size. Additionally, they can be attached to dental implants to replace missing teeth, acting as an alternative to bridges or removable dentures.
But, durable and natural-looking crowns require a degree of skill, both in the clinical and laboratory stages, explains DR STEVEN SOO, dental specialist in prosthodontics at Specialist Dental Group. The dental clinic offers a variety of different types of crowns, depending on the needs and preferences of the patient.
In the past, metal crowns – both precious metal (gold alloy) and non-precious metal – have been used as the industry standard. But, despite their durability, they fell short in the aesthetic department.
So, dentists began fusing porcelain to metal crowns to create a more natural appearance, anchored by the metal’s strength. However, porcelain’s propensity to chip or break easily makes the material less than ideal for back teeth, where the bite forces are stronger. What’s more, metal and porcelain crowns require a multi-step manufacturing process – one that’s dependent on the manual skills of a well-trained dental technician, explains Dr Soo.
These days, crowns made from zirconium have replaced metal and porcelain ones as the preferred choice. And for good reason.
Called monolithic zirconia crowns, they are entirely ceramic restorations, made with a totally different technique than their metal counterparts.
“The dental impression of the tooth is 3D laser scanned to provide a virtual tooth. Software tooth design is used to model the final crown to fit well with the adjacent and opposing teeth,” says Dr Soo.
“The use of computer-aided design (CAD) and computeraided manufacturing (CAM) results in a consistent product that is less dependent upon individual skill, while the use of monolithic zirconia ensures a strong, homogenous material.”
In addition to its durability, he says zirconia is highly scratch resistant with excellent biocompatibility; in fact, plaque doesn’t even stick well to zirconia!
What’s more, the translucent, metal-free, more natural appearance of monolithic zirconia crowns makes them suitable for capping even the most visible front teeth.
This article on Singapore Dentists first appeared in the July 2022 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy!
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